在高级痴呆症患者的提前安乐死指令上的难题导航
Djura O Coers1, Eefje M Sizoo1, Maryam Bloemen2
1Amsterdam University Medical Center, Location Vrije Universiteit Amsterdam, Department of Medicine for Older People, Faculty of Medicine, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands.
Journal of the American Medical Directors Association
|October 13, 2024
概括
对于痴呆症患者,医生面临着提前安乐死指令 (AED) 的挑战,特别是在沟通和评估痛苦方面. 虽然ECP优先考虑沟通,但EEC医生专注于痛苦,这两组都重视患者的意见.
科学领域:
- 医学伦理 医学伦理
- 老年医学 老年医学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 预先安乐死指令 (AED) 在荷兰对晚期痴呆症患者具有法律认可.
- 医生在满足该人口安乐死的尽职尽责标准时遇到道德上的复杂性.
- 挑战包括患者沟通和评估非决策能力患者的难以忍受的痛苦.
研究的目的:
- 探索医生在处理高级痴呆症患者的AED安乐死请求时所面临的复杂性.
- 检查老年护理医生 (ECP) 的观点,支持和咨询荷兰安乐死 (SCEN) 的医生,以及安乐死专业中心 (EEC) 的医生.
主要方法:
- 一个多方法描述性研究,使用一个包含闭式和开放式问题的问卷.
- 分析涉及基线特征的描述性统计数据和子组变异的单变量回归.
- 使用主题内容分析分析了定性数据.
主要成果:
- 共有290名医生参与 (13.8%的应答率),包括ECP,SCEN医生和EEC医生,其中一些医生担任联合角色.
- 老年护理医生 (ECP) 收到了大多数基于AED的安乐死请求,但很少有安乐死程序由EEC或SCEN医生进行.
- 所有医生子组都强调了患者沟通,当前安乐死愿望和验证无法忍受的痛苦的关键重要性,ECP将道德理由与沟通联系起来.
结论:
- 尽管收到基于AED的安乐死请求,但进行安乐死的医生人数很少.
- 小组分析揭示了不同的观点:ECP优先考虑沟通,而EEC医生专注于评估无法忍受的痛苦.
- 所有医生团体都强调了当前患者表达和参与AED安乐死决策过程的重要性.
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